Provider Demographics
NPI:1215106315
Name:RAPHA HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:RAPHA HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOJISOLA
Authorized Official - Middle Name:CLARA
Authorized Official - Last Name:FAPOHUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-740-3138
Mailing Address - Street 1:5916 NORWAY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5733
Mailing Address - Country:US
Mailing Address - Phone:410-740-3138
Mailing Address - Fax:443-393-0261
Practice Address - Street 1:5916 NORWAY CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-5733
Practice Address - Country:US
Practice Address - Phone:410-740-3138
Practice Address - Fax:443-393-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2465251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health